9 0 001 ≥10 9 45 <10 24 24 Serum albumin,g/L 20 05 0

of TRAF6 protein in muscle of cancer patients and control. The AICAR clinical trial expression of ubiquitin in muscle of control and cancer patients We assessed the expression of ubiquitin in 29 control muscles and 102 patient muscles. Ubiquitin was significantly upregulated in muscle of gastric cancer compared with the control muscles (P 0.05) (Table 3). In order to analyze the expression of ubiquitin protein with quantitation, 8 muscle of control and cancer patients were detectec by western blotting, the study indicated the expression of ubiquitin in 5 muscle of cancer patients were higher than control (Figure 2). Table 3 The expression of ubiquitin

expression of both TRAF6 and ubiquitin. There was significant between GPX6 TRAF6 and ubiquitin expression (χ 2 =6.68; P = 0.01) (Table 4, Figure 3). Table 4 Association between expression of TRAF6 and ubiquitin Clinical parameters TRAF6 high low χ2 P ubiquitin 20.05 0.001 high 51(85.0%) 9(15.0%) low 18(42.9%) 24(57.1%) Figure 3 Association between expression of TRAF6 and ubiquitin. Discussion In healthy individuals, skeletal muscle metabolism requires a balance of anabolic and catabolic processes, resulting in a continuous renewal of muscle proteins without a net change in overall muscle mass. However, in cancer cachexia and other chronic illnesses, the muscle wasting were associated with the reduced rate of protein synthesis, increased protein degradation, or a combination of both contributes [13]. One common mechanism associated with skeletal muscle protein degradation in cancer cachexia is the activation of the adenosine triphosphate-dependent ubiquitin-proteasome proteolytic path way, this system plays a major role in muscle wasting [5, 6]. The study showed muscle ubiquitin mRNA was hyper expressed in gastric cancer patients compared to controls [14], the ubiquitin-proteasome proteolytic system play important role in the pathogenesis of muscle protein hyper catabolism in cancer cachexia. To investigate the role of ubiquitin expression in the skeletal muscle of gastric cancer patients.